Provider Demographics
NPI:1063774305
Name:HOLMAN, MELISSA LYNN (LMFT)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:LYNN
Last Name:HOLMAN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1035 MARKET ST STE 400
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1665
Mailing Address - Country:US
Mailing Address - Phone:415-487-3108
Mailing Address - Fax:
Practice Address - Street 1:1035 MARKET ST
Practice Address - Street 2:FLOOR 4
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1600
Practice Address - Country:US
Practice Address - Phone:415-487-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69449101YA0400X, 101YM0800X, 171M00000X, 174H00000X, 106H00000X
CA98190106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator